Aripiprazole Risks, Warnings, and Complications

Precautions Before Starting Aripiprazole

Tell your doctor if you have had an unusual or allergic reaction to aripiprazole, any of the active or inactive ingredients in aripiprazole formulations, other atypical antipsychotics, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, nonprescription drugs, vitamins, supplements, and herbal products such as St. John’s Wort. This can help avoid possible interactions between aripiprazole and your other medicines.

Give your doctor a complete medical history. Aripiprazole may not be right for people with certain health conditions, such as dehydration, vomiting, diarrhea, irregular heartbeat, heart failure, heart attack, heart disease, low or high blood pressure, high cholesterol, stroke or mini-strokes, seizures, low blood cell counts, balance problems, or swallowing problems. Also, inform your doctor if you have a personal or family history of substance abuse (alcohol, illegal drugs, or prescription drugs), diabetes, bipolar disorder, impulse control problems, or obsessive-compulsive disorder. Tell your healthcare provider if you ever had to discontinue a mental illness medication because of intolerable or severe adverse effects.

Tell your doctor if you are currently pregnant, could be pregnant, are planning a pregnancy, or are breastfeeding. Aripiprazole can be harmful to the newborn baby if the mother takes this medicine during late pregnancy.

Precautions During Use of Aripiprazole

Keep all your medical and lab appointments while on aripiprazole. Tell your health care professional if your symptoms do not improve or get worse after a few weeks of treatment with this medicine. Do not change the dose or dosing frequency or stop taking aripiprazole without talking to your doctor first.

Aripiprazole can make you feel drowsy and dizzy. Exercise caution while driving and during other potentially hazardous activities until you are sure you don’t have these side effects. Alcohol can make these side effects worse. Avoid drinking alcohol while on aripiprazole.

Aripiprazole can cause lightheadedness, dizziness, and fainting upon changing positions from sitting or lying to standing. When you get out of bed, do so slowly by resting your feet on the ground for a short period before standing up. Tell your doctor if the dizziness is severe or does not go away after a few days.

Aripiprazole can cause high blood sugar and may cause or worsen diabetes. If you have a diagnosis of diabetes, talk to your doctor about how often you should measure your blood sugar levels. The oral solution of aripiprazole contains sugar and may affect blood glucose levels. Tell your doctor if you develop signs and symptoms such as increased thirst, increased hunger, frequent urination, weakness, and blurred vision. Seek emergency medical care if you develop signs of diabetic ketoacidosis, such as nausea, vomiting, dry mouth, fruity-smelling breath, shortness of breath, and loss of consciousness. 

Aripiprazole can make it harder for you to cool down. Avoid strenuous exercise in hot weather. Stay well hydrated. Seek immediate medical care if you develop signs and symptoms of overheating, such as dizziness, weakness, thirst, weak and rapid pulse, or muscle cramps. 

The orally disintegrating tablets of aripiprazole contain phenylalanine and are not suitable for people with a condition called phenylketonuria (PKU). 

Talk to your provider about eating grapefruit and drinking grapefruit juice while on aripiprazole.

In children with autism spectrum disorders and Tourette’s syndrome, antipsychotic drugs such as aripiprazole are part of a comprehensive treatment plan that includes counseling, psychotherapy, and special education plans. Follow your child’s provider’s recommendations to get the maximum benefit from this medicine. 

Tell all your healthcare providers you are on aripiprazole, especially before any surgical procedures, including dental treatments.

Tell your healthcare professional without delay if you become pregnant while on aripiprazole.

Aripiprazole Drug Interactions

Taking aripiprazole with certain other drugs can affect how the medicines work. Possible interactions between aripiprazole and other medications can increase the risk of serious adverse events. Your doctor may change the dose of your medications, switch you to another medication, or monitor you carefully for side effects if there are known interactions between aripiprazole and your other medicines. Aripiprazole can have drug interactions with the following medications:

• Antidepressants such as fluoxetine (Prozac, Sarafem), nefazodone, paroxetine (Paxil, Pexeva) 
• Antidepressants and smoking cessation aids such as bupropion (Wellbutrin) 
• Antifungal medications such as ketoconazole and itraconazole (Onmel, Sporanox)
• Antihistamines
• Certain antibiotics such as clarithromycin (Biaxin), rifabutin (Mycobutin), and rifampin (Rifadin, Rimactane)
• HIV medications such as ritonavir (Norvir), efavirenz (Sustiva), atazanavir (Reyataz), indinavir (Crixivan), nevirapine (Viramune), nelfinavir (Viracept), and saquinavir (Invirase)
• Medications prescribed for lung conditions, such as ipratropium (Atrovent)
• Medications for motion sickness, high blood pressure, anxiety, ulcers, irritable bowel syndrome, urinary problems, mental illness, and Parkinson's disease
• Anti-anxiety drugs like lorazepam (Ativan)
• Diabetes medications such as pioglitazone (Actos, in Oseni)
• Medications used to treat irregular heart beats, such as quinidine (in Nuedexta)
• Anti-seizure medications such as carbamazepine (Tegretol, Carbatrol, Epitol, others), phenytoin (Phenytek, Dilantin), and phenobarbital
• Sedatives, sleeping pills, and tranquilizers

The above list may not include all the possible drug interactions of aripiprazole. Give your health care professional a complete list of all the medications you are taking, including prescription drugs, non-prescription medicines, dietary supplements, and herbal remedies. Also, tell your healthcare provider if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription and over-the-counter medicines.